RN Immigration: RX for Health Worker Crisis in the U.S.

by Cristina A. Godinez, Esq.

| Photo by JD Lasica via Flickr/Commons CC BY 2.0

The COVID-19 pandemic pulled away the curtain that used to hide the severity of the nursing shortage in the United States, and lives are at stake.

Lingering Shortage of Nurses in the U.S.

The U.S. healthcare system has barely survived a lingering shortage of registered nurses (RNs) for decades. Long before the pandemic, the rise in demand for more RNs had been brought about by an aging population with chronic conditions and an impending retirement wave of Baby Boomer nurses and other healthcare professionals.

With the COVID-19 pandemic showing no signs of going away soon, the demand for RNs in the U.S. is expected to intensify further. From 2020 to 2030, the U.S. healthcare industry would need 200,000 nurses every year, according to the latest projection of the U.S. Bureau of Labor Statistics.

Ignoring the severity of the nursing shortage in the U.S. can lead to fatal consequences – errors that could result in the worsening of the patient’s condition, if not higher morbidity or mortality rates among patients.

Effect of COVID-19 on Nursing Shortage

The COVID-19 Survey Series conducted by the American Nurses Foundation confirmed widespread workplace burnouts among nurses, with half of the nurses stating they are considering leaving their positions. Coupled with an aging nurse population (over one-third of nurses are 55 years old or older) and vulnerable young nurses struggling with the workplace trauma of the pandemic, this signals the need for a forward-looking solution to a U.S. healthcare crisis that is staring at us.

“Ignoring the severity of the nursing shortage in the U.S. can lead to fatal consequences – errors that could worsen the patient’s condition, if not higher morbidity or mortality rates among patients.”

Nurses in the U.S. healthcare system routinely engage in double shifts, excessive overtime, and work with higher patient-to-nurse ratios. It is not the way to keep nurses working at their best. Worse, these practices will inevitably lead to higher risks to patient safety and care.

Efforts to develop a nursing workforce within the U.S. are not working. In fact, U.S. nursing schools have turned away nearly 100,000 qualified applicants in 2019 from baccalaureate and graduate nursing programs primarily due to a lack of nursing faculty and/or clinical preceptors.

Meanwhile, healthcare facilities that refuse to commit to long-term staffing solutions eventually find themselves relying more on short-term measures like hiring traveling nurses. An ICU nurse in a Lakewood, CO hospital earning about $800 per week reportedly left her job and became a traveling nurse in a COVID-19 hotspot in New Jersey, earning $5,200 per week. In other states, traveling nurses could earn as much as $8,000 a week. With nurses moving to more affluent medical facilities for higher pay, many small rural hospitals are left understaffed and unable to care for their patients properly.

Nurse Immigration to the U.S.

To this day, the U.S. government has been slow and tentative to a nursing crisis that demands rapid response.

Many medical facilities have been reluctant to sponsor foreign-trained nurses for green cards due to the lengthy process it takes to get the nurses here – and with good reason. U.S. immigration law has fixed yearly visa quotas per country for immigrant worker immigration. These visa quotas have proven to be unrealistic given the higher global mobility of workers. As a result, these visa quotas typically fall short of the demand every year, which, in turn, result in severe backlogs in U.S. immigrant visa applications.

“Despite the massive exit of nurses during the COVID-19 pandemic, the only response thus far is a bipartisan bill aimed at recapturing 25,000 unused visas for nurses, which remains stalled in Capitol Hill as of this writing.”

Temporary worker visas, such as the H-1A and H-1C programs, are an option specifically designed to allow foreign nurses to work in the U.S. for short periods. But these programs also fell short of the U.S. need for nurses because of yearly visa quotas. These programs eventually expired and were not replaced by any other nurse or health worker visa program.

Apparently, the U.S. Congress is still unable to consider foreign nurse immigration as a viable and long-term solution to the chronic nursing shortage. Despite the massive exit of nurses during the COVID-19 pandemic, the only response thus far is a bipartisan bill aimed at recapturing 25,000 unused visas for nurses, which remains stalled in Capitol Hill as of this writing.

In the meantime, an estimated 5,000 foreign nurses already approved for work in the U.S. are still waiting for the State Department to process their immigrant visas because the employment-based visa category was designated as the lowest priority.

These half-hearted attempts at resolving the nursing shortage, however, are simply not enough. Any move toward comprehensive immigration reform should include an efficient and expeditious pathway for foreign-trained nurses to come to the U.S. and resuscitate its ailing healthcare system.
(Up next: Immigration options for Filipino nurses today)

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Cristina Godinez is an attorney who has provided immigration solutions to families, businesses, and at-risk migrants in the United States for over 15 years, focusing on the immigration of foreign nurses and other healthcare workers. She worked with the immigration law practice group of a top-tier global law firm and later with the world’s largest immigration law firm. She developed the immigration legal services program at the faith-based Migrant Center of New York. Cristina is a member of the American Immigration Lawyers Association.

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